In Oceana, West Virginia, painkiller addiction is so common that some don’t even call the town by its name anymore. They call it Oxyana.

Filmmaker Sean Dunne – best known for his 2011 short documentary American Juggalo– happened upon the town during a road trip last year and later returned to document the epidemic. His film, Oxyana, tells the story of a once-prosperous mining community disintegrating into poverty, mistrust, and violence. Dunne's respectful interviews and collaborator Hillary Spera's stark cinematography underpin brave and open testimonials from doctors, dealers, addicts, and their families.

In this excerpt, residents describe how far they’ll go to pay for black market pills. And in the interview below, Dunne shares how he decided to film in Oceana and his personal connection to the subject. You can watch the full film on Vimeo On Demand, iTunes, or Amazon.

The Atlantic: Your documentary work often focuses on people at the wayside of society. What drew you to Oceana?

Sean Dunne: I stumbled upon Oceana on a road trip from Virginia to Nashville that I was taking with musician Jonny Fritz. Some of his friends in Virginia suggested stopping there for the night, as it was a popular ATV destination. Once we arrived in the area we spotted a local Juggalo named Jason who told us a little about the area, things to do, etc. At one point he took me aside and started talking about pills, namely Oxycontin. Within 15 minutes he was shooting a pill into his hand. It was absolutely shocking, I’d never seen anything like that. He told us that pills ruled everything in the area and that it had gotten so bad that locals referred to it as Oxyana. We left a day or two later but Jason and this small town's struggle stuck with me. My father had struggled with prescription pill abuse when I was growing up and it destroyed his life. I couldn’t fathom that this was going on in such a concentration in Oceana, so I decided to go back and dig around a little more.

In the film, you're with people in their homes in very intimate moments. How did you get access? And why do you think people opened up to you so quickly?

We wanted the film to be told through the voices of the addicts and those directly affected by the epidemic. That required us to be in intimate, sometimes dangerous scenarios. Access was a concern before we started shooting but once we were there it wasn’t an issue. Word had spread that we were filming in the area so some people were coming to us with their stories. Others we found through friends like Jason or by happenstance. It all felt very natural, nothing was forced. That was important to us and we wanted the film to reflect that. I think their willingness to be so revealing is a testament to how desperate the situation has become in Southern West Virginia. They saw the opportunity to have their voices heard by outsiders and they used it.

How have residents reacted to the film's portrayal of their hometown?

Before we released the film, we were faced with a fair number of skeptics within Oceana. That was understandable and expected considering how sensitive this subject is and the stigma that comes along with it. But once people started to see the film, we started to see a different reaction that surprised us even more: people from the area began to write us and thank us for exposing the issue. And while there are still some from the area who would have preferred us to not make the film in their town, everyone agrees that prescription drug abuse in the area is an epidemic that needs to be addressed.

Are there any updates on the town or the people you interviewed?

Slowly but surely help seems to be on the way. The film helped increase awareness and got the attention of many lawmakers. I think it’s going to take some time before you see real change because there are no easy solutions to a problem like this. Obviously the drug war has failed West Virginia and this country as a whole. Caging drug users seems to do nothing to curb the problem. It’s going to take some big ideas and outside the box thinking to ultimately solve an issue this widespread and that doesn’t happen overnight.

Some of our interviewees have gotten cleaned up, some have spiraled worse out of control. It’s very hard to keep in touch with them, as many don’t have phones or steady addresses. We hear things from time to time but it’s hard to decipher between small town gossip and reality when you’re not actually there.

What are you working on next?

My next feature documentary is called Cam Girlz. It’s about women who make their living doing sex shows on the internet from the comfort and safety of their own homes. It’s such a fascinating little community, so many issues at play. Expect that sometime next year.

Most Popular

Writing used to be a solitary profession. How did it become so interminably social?

Whether we’re behind the podium or awaiting our turn, numbing our bottoms on the chill of metal foldout chairs or trying to work some life into our terror-stricken tongues, we introverts feel the pain of the public performance. This is because there are requirements to being a writer. Other than being a writer, I mean. Firstly, there’s the need to become part of the writing “community”, which compels every writer who craves self respect and success to attend community events, help to organize them, buzz over them, and—despite blitzed nerves and staggering bowels—present and perform at them. We get through it. We bully ourselves into it. We dose ourselves with beta blockers. We drink. We become our own worst enemies for a night of validation and participation.

Even when a dentist kills an adored lion, and everyone is furious, there’s loftier righteousness to be had.

Now is the point in the story of Cecil the lion—amid non-stop news coverage and passionate social-media advocacy—when people get tired of hearing about Cecil the lion. Even if they hesitate to say it.

But Cecil fatigue is only going to get worse. On Friday morning, Zimbabwe’s environment minister, Oppah Muchinguri, called for the extradition of the man who killed him, the Minnesota dentist Walter Palmer. Muchinguri would like Palmer to be “held accountable for his illegal action”—paying a reported $50,000 to kill Cecil with an arrow after luring him away from protected land. And she’s far from alone in demanding accountability. This week, the Internet has served as a bastion of judgment and vigilante justice—just like usual, except that this was a perfect storm directed at a single person. It might be called an outrage singularity.

Forget credit hours—in a quest to cut costs, universities are simply asking students to prove their mastery of a subject.

MANCHESTER, Mich.—Had Daniella Kippnick followed in the footsteps of the hundreds of millions of students who have earned university degrees in the past millennium, she might be slumping in a lecture hall somewhere while a professor droned. But Kippnick has no course lectures. She has no courses to attend at all. No classroom, no college quad, no grades. Her university has no deadlines or tenure-track professors.

Instead, Kippnick makes her way through different subject matters on the way to a bachelor’s in accounting. When she feels she’s mastered a certain subject, she takes a test at home, where a proctor watches her from afar by monitoring her computer and watching her over a video feed. If she proves she’s competent—by getting the equivalent of a B—she passes and moves on to the next subject.

The Wall Street Journal’s eyebrow-raising story of how the presidential candidate and her husband accepted cash from UBS without any regard for the appearance of impropriety that it created.

The Swiss bank UBS is one of the biggest, most powerful financial institutions in the world. As secretary of state, Hillary Clinton intervened to help it out with the IRS. And after that, the Swiss bank paid Bill Clinton $1.5 million for speaking gigs. TheWall Street Journal reported all that and more Thursday in an article that highlights huge conflicts of interest that the Clintons have created in the recent past.

The piece begins by detailing how Clinton helped the global bank.

“A few weeks after Hillary Clinton was sworn in as secretary of state in early 2009, she was summoned to Geneva by her Swiss counterpart to discuss an urgent matter. The Internal Revenue Service was suing UBS AG to get the identities of Americans with secret accounts,” the newspaper reports. “If the case proceeded, Switzerland’s largest bank would face an impossible choice: Violate Swiss secrecy laws by handing over the names, or refuse and face criminal charges in U.S. federal court. Within months, Mrs. Clinton announced a tentative legal settlement—an unusual intervention by the top U.S. diplomat. UBS ultimately turned over information on 4,450 accounts, a fraction of the 52,000 sought by the IRS.”

An attack on an American-funded military group epitomizes the Obama Administration’s logistical and strategic failures in the war-torn country.

Last week, the U.S. finally received some good news in Syria:.After months of prevarication, Turkey announced that the American military could launch airstrikes against Islamic State positions in Syria from its base in Incirlik. The development signaled that Turkey, a regional power, had at last agreed to join the fight against ISIS.

The announcement provided a dose of optimism in a conflict that has, in the last four years, killed over 200,000 and displaced millions more. Days later, however, the positive momentum screeched to a halt. Earlier this week, fighters from the al-Nusra Front, an Islamist group aligned with al-Qaeda, reportedly captured the commander of Division 30, a Syrian militia that receives U.S. funding and logistical support, in the countryside north of Aleppo. On Friday, the offensive escalated: Al-Nusra fighters attacked Division 30 headquarters, killing five and capturing others. According to Agence France Presse, the purpose of the attack was to obtain sophisticated weapons provided by the Americans.

There’s no way this man could be president, right? Just look at him: rumpled and scowling, bald pate topped by an entropic nimbus of white hair. Just listen to him: ranting, in his gravelly Brooklyn accent, about socialism. Socialism!

And yet here we are: In the biggest surprise of the race for the Democratic presidential nomination, this thoroughly implausible man, Bernie Sanders, is a sensation.

He is drawing enormous crowds—11,000 in Phoenix, 8,000 in Dallas, 2,500 in Council Bluffs, Iowa—the largest turnout of any candidate from any party in the first-to-vote primary state. He has raised $15 million in mostly small donations, to Hillary Clinton’s $45 million—and unlike her, he did it without holding a single fundraiser. Shocking the political establishment, it is Sanders—not Martin O’Malley, the fresh-faced former two-term governor of Maryland; not Joe Biden, the sitting vice president—to whom discontented Democratic voters looking for an alternative to Clinton have turned.

During the multi-country press tour for Mission Impossible: Rogue Nation, not even Jon Stewart has dared ask Tom Cruise about Scientology.

During the media blitz for Mission Impossible: Rogue Nation over the past two weeks, Tom Cruise has seemingly been everywhere. In London, he participated in a live interview at the British Film Institute with the presenter Alex Zane, the movie’s director, Christopher McQuarrie, and a handful of his fellow cast members. In New York, he faced off with Jimmy Fallon in a lip-sync battle on The Tonight Show and attended the Monday night premiere in Times Square. And, on Tuesday afternoon, the actor recorded an appearance on The Daily Show With Jon Stewart, where he discussed his exercise regimen, the importance of a healthy diet, and how he still has all his own hair at 53.

Stewart, who during his career has won two Peabody Awards for public service and the Orwell Award for “distinguished contribution to honesty and clarity in public language,” represented the most challenging interviewer Cruise has faced on the tour, during a challenging year for the actor. In April, HBO broadcast Alex Gibney’s documentary Going Clear, a film based on the book of the same title by Lawrence Wright exploring the Church of Scientology, of which Cruise is a high-profile member. The movie alleges, among other things, that the actor personally profited from slave labor (church members who were paid 40 cents an hour to outfit the star’s airplane hangar and motorcycle), and that his former girlfriend, the actress Nazanin Boniadi, was punished by the Church by being forced to do menial work after telling a friend about her relationship troubles with Cruise. For Cruise “not to address the allegations of abuse,” Gibney said in January, “seems to me palpably irresponsible.” But in The Daily Show interview, as with all of Cruise’s other appearances, Scientology wasn’t mentioned.

The Islamic State is no mere collection of psychopaths. It is a religious group with carefully considered beliefs, among them that it is a key agent of the coming apocalypse. Here’s what that means for its strategy—and for how to stop it.

What is the Islamic State?

Where did it come from, and what are its intentions? The simplicity of these questions can be deceiving, and few Western leaders seem to know the answers. In December, The New York Times published confidential comments by Major General Michael K. Nagata, the Special Operations commander for the United States in the Middle East, admitting that he had hardly begun figuring out the Islamic State’s appeal. “We have not defeated the idea,” he said. “We do not even understand the idea.” In the past year, President Obama has referred to the Islamic State, variously, as “not Islamic” and as al-Qaeda’s “jayvee team,” statements that reflected confusion about the group, and may have contributed to significant strategic errors.

Some say the so-called sharing economy has gotten away from its central premise—sharing.

This past March, in an up-and-coming neighborhood of Portland, Maine, a group of residents rented a warehouse and opened a tool-lending library. The idea was to give locals access to everyday but expensive garage, kitchen, and landscaping tools—such as chainsaws, lawnmowers, wheelbarrows, a giant cider press, and soap molds—to save unnecessary expense as well as clutter in closets and tool sheds.

The residents had been inspired by similar tool-lending libraries across the country—in Columbus, Ohio; in Seattle, Washington; in Portland, Oregon. The ethos made sense to the Mainers. “We all have day jobs working to make a more sustainable world,” says Hazel Onsrud, one of the Maine Tool Library’s founders, who works in renewable energy. “I do not want to buy all of that stuff.”

Jim Gilmore joins the race, and the Republican field jockeys for spots in the August 6 debate in Cleveland.

After decades as the butt of countless jokes, it’s Cleveland’s turn to laugh: Seldom have so many powerful people been so desperate to get to the Forest City. There’s one week until the Republican Party’s first primary debate of the cycle on August 6, and now there’s a mad dash to get into the top 10 and qualify for the main event.

With former Virginia Governor Jim Gilmore filing papers to run for president on July 29, there are now 17 “major” candidates vying for the GOP nomination, though that’s an awfully imprecise descriptor. It takes in candidates with lengthy experience and a good chance at the White House, like Scott Walker and Jeb Bush; at least one person who is polling well but is manifestly unserious, namely Donald Trump; and people with long experience but no chance at the White House, like Gilmore. Yet it also excludes other people with long experience but no chance at the White House, such as former IRS Commissioner Mark Everson.